Department of Endocrinology and Metabolism, Odense University Hospital, Odense, Denmark.
Fertil Steril. 2011 Nov;96(5):1275-80. doi: 10.1016/j.fertnstert.2011.08.035. Epub 2011 Oct 6.
To study hemoglobin A1c (HbA1c) as a tool for diagnosing diabetes and to study HbA1c as a cardiovascular risk marker in patients with polycystic ovary syndrome (PCOS).
Retrospective observational study.
Academic tertiary-care medical center.
PATIENT(S): Two hundred eight premenopausal women with PCOS.
INTERVENTION(S): Patients underwent clinical evaluation (Ferriman-Gallwey score, body mass index, waist, blood pressure), hormone analyses (T, sex hormone-binding globulin, fasting lipids, insulin, glucose, HbA1c), transvaginal ultrasound, and 2-hour oral glucose tolerance tests (OGTT) measuring capillary blood glucose (BG) at 0 (BG 0) and 120 (BG 120) minutes, insulin, and C-peptide.
MAIN OUTCOME MEASURE(S): Results of OGTT, HbA1c values.
RESULT(S): Twenty patients were diagnosed with type 2 diabetes during OGTT. The sensitivity and specificity of HbA1c ≥6.5% for the diagnosis of diabetes were 35% and 99%, respectively, compared with the diagnosis established by OGTT. Hemoglobin A1c showed closer correlation with waist, body mass index, and lipid profile than BG 120, suggesting that HbA1c could be a cardiovascular risk marker.
CONCLUSION(S): The clinical utility of HbA1c for diagnosing impaired glucose tolerance and type 2 diabetes in PCOS in daily practice is low. Long-term prospective studies are needed to determine whether HbA1c is superior to glucose levels as a cardiovascular risk marker in patients with PCOS.
研究糖化血红蛋白（HbA1c）作为诊断糖尿病的工具，并研究 HbA1c 作为多囊卵巢综合征（PCOS）患者心血管风险标志物的作用。
回顾性观察性研究。
学术性三级保健医疗中心。
208 例患有 PCOS 的绝经前妇女。
患者接受临床评估（Ferriman-Gallwey 评分、体重指数、腰围、血压）、激素分析（T、性激素结合球蛋白、空腹血脂、胰岛素、血糖、HbA1c）、阴道超声以及 2 小时口服葡萄糖耐量试验（OGTT），测量毛细血管血糖（BG）在 0 分钟（BG0）和 120 分钟（BG120）、胰岛素和 C 肽。
OGTT 结果、HbA1c 值。
20 例患者在 OGTT 中被诊断为 2 型糖尿病。HbA1c≥6.5%用于诊断糖尿病的敏感性和特异性分别为 35%和 99%，与 OGTT 诊断相比。HbA1c 与腰围、体重指数和血脂谱的相关性比 BG120 更密切，提示 HbA1c 可能是心血管风险标志物。
HbA1c 用于诊断 PCOS 患者葡萄糖耐量受损和 2 型糖尿病的临床实用性在日常实践中较低。需要进行长期前瞻性研究，以确定 HbA1c 是否优于血糖水平作为 PCOS 患者的心血管风险标志物。
